Hepatobilijarna scintigrafija u proceni funkcije transplantirane jetre

The aim of the study is evaluation of hepatocellular function, as well as morphology and patency of the biliary three of the liver transplants by dynamic hepatobiliary scintigraphy. The study was performed in 10 controls and 10 patients after orthotopic transplantation (up to two years). Sixty minutes dynamic acquisition (1 frame/min) was performed with scintillation camera after injection of 360 MBq 99mTc-diethyl-IDA. Hepatobiliary scintigrams were analysed for morphology, and parenchymal and hepatobiliary TA curves were generated and analysed as regard to the time to maximal acitivity (Tmax) and the time to half of maximum acitivity (T1/2). Uptake of the radiopharmaceutical was slightly but not significantly delayed (Tmax=18.5+2.9 min) in comparison to the controls (Tmax=14.2+ 3.4min), while excretion was significantly prolonged (T1/2=59.5+ 12.1 min) than physiological (Tmax=34.2+4.1min). Intrahepatic bile flow was nonsignificantly prolonged (Tmax=31.3+3.7 min) in comparison to the controls (Tmax=25.7+ 3.5 min) while extrahepatic one is high significantly prolonged (T1/2=89.0+14.3 min) than physiological (T1/2 =45.0+ 7.2 min). Biliary phase of hepatobiliary scintigraphy showed increased accumulation of radiopharmaceutical in the left (n=1) or right (n=2) hepatic duct. Radionuclide methods are noninvasive, and apear to be sensitive and valuable for the monitoring of liver transplants. Cilj rada je procena funkcije jetrinog parenhima, kao i morfologije i prolaznosti bilijarnog stabla transplantirane jetre pomocu dinamske hepatobilijarne scitigrafije. Ispitivanje je uradjeno na deset osoba do 2 godine posle ortotopicke trensplantacije jetre i deset kontrola. Preuzimanje radiofarmaka je, u poredjenju sa kontrolnom grupom Tmax = 14.2+ 3.4 min (x SD) bilo blago, statisticki nesignifikantno produzeno Tmax = 18.5+ 2.9 min, dok je eliminacija radiofarmaka iz parenhima trajala znacajno duze T1/2 = 59.5+12.1 min od fizioloske T1/2 = 34.2+ 4.1 min. Protok kroz intrahepaticke zucne puteve Tmax=31.3+3.7 min se nije statisticki znacajno razlikovao od kontrolne grupe Tmax=25.7+3.5 min, dok je protok kroz ekstrahepaticne zucne puteve T1/2=89.0+14.3 min statisticki visoko signifikantno produzen u poredjenju sa fizioloskim T1/2=45.0+7.2 min. Neinvazivne i visoko senzitivne, metode nuklearne medicine su od velike koristi u proceni funkcionog stanja transplantirane jetre.